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When it comes to open mesh, I really meant just Lichtenstein style. The docs in this area say they can all do an open mesh repair but their volume and expertise is in minimally invasive techniques like laparoscopic/robotic.

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Looking at Medtronic’s webpage on the advantages of ProGrip, are they substantiated? It seems no fixation required as compared to Bard 3D Max, and almost half is reabsorbed along with the microgrips. But does the microgrips cause more inflammation? I suppose this is the acommodation that is required. Thus, would ProGrip be technically more preferable overall? Thoughts?

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Thank you for the link. I was inquiring specifically if there are mesh designed specifically for open and ones specifically designed for laparoscopic. I wasn’t sure if surgeons used the same identical mesh. I assumed that the open technique would allow for a lighter weight and smaller mesh because it’s a posterior repair as opposed to laparoscopic. I was not sure if this was the case.

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Speaking of an open lichtenstein, would Dr. David Chen be the BEST surgeon to have one done? It seems he has really perfected and tailored the technique.

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Does anyone also know if these ProGrip meshes are better than mesh requiring sutures? I would imagine the ProGrip ones are marketing a self-fixating so without the use of tacks, sutures, or staples.

How do these self-gripping meshes compare with pain level and complication risks with regards to traditional sutures/tacks/staples?

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I posted a similar thread a few weeks ago on non-mesh surgeons that I was able to find in the Los Angeles region: https://herniatalk.com/forums/topic/non-mesh-doctor-recommendations-near-the-los-angeles-area/.

Non-mesh doctor recommendations near the Los Angeles area?

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Thanks for the recommendation. It looks like he is not in that area.

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sensei_305, do you know if Dr. Billing does non-mesh or tissue-based repairs for hernias? When looking up his information, I see that he specializes in weight loss specialties, so it was kind of odd seeing that he does hernia mesh removal as well.

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Thanks for the recommendations, everyone. If you have more experiences in Oregon/Washington/California (or even Idaho/Nevada), please let me know. I am trying to do my research on the best potential surgeon that specializes or can do a sufficient tissue repair.

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After consulting with a previous surgeon, he suggested no surgery due to no palpable bulge. I believe Shouldice would also mirror the same recommendation as they do not operate if there is no physical bulge. My main issue is I’m in a picky dilemma where I am mildy asymptomatic and the surgeon isn’t convinced that my symptoms are from the small hernia that is only reproducible on supine ultrasound with valsalva.

However, going back to your remarks on Dr. Orenstein — why do you suggest he is firm in the mesh camp whereas Dr. Martindale is more open? I know he also did a talk with Dr. Towfigh as well.

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Thanks for the recommendation. OHSU seems like it would be great. The surgeons there would be a good fit. Just viewed that video and it appears Dr. Martindale is truly an expert with ample experience. The only consideration is that he is in his 70’s, so I wasn’t sure if down the road if I were to need revision surgery, he would probably be retired.

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Thanks for the replies. I reside in the NW, hence, I was looking for surgeons close to me. However, I am fully aware of the other surgeons you mentioned that are farther East. Dr. Towfigh in California would be the closest travel.

However, going back to your statement regarding “being extremely careful when selecting a surgeon” — are you referring to surgeons that are doing non-mesh ala tissue suture repairs, or are you talking about any surgeon in general? If the former, that makes sense, as tissue repair surgeons (unless they’re trained or specialized like at Shouldice) are more rare. It appears majority of hernias are done with mesh, however, I believe I have a small hernia that may be better suited with tissue repair.

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I am located pretty close to Dr. Peter Billing for a inguinal repair consultation. However, while I have heard he can remove mesh, do you know if he offers non-mesh repairs? I’m trying to find a surgeon locally who can do a non-mesh repair, if feasible. Thank you.

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Which surgeon in the Seattle area would you recommend for a tissue repair?

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Most of the surgeons in my area either use Bard 3D Max Polypropylene or ProGrip Polyester for their laparoscopic repairs. Out of those two, would ProGrip be more preferred then?